United States District Court, S.D. Illinois
MEMORANDUM AND ORDER
STEPHEN C. WILLIAMS UNITED STATES MAGISTRATE JUDGE
pro se, Plaintiff Juan Garcia brought the present
lawsuit pursuant to 42 U.S.C. § 1983. An inmate at
Menard Correctional Center (“Menard”), Plaintiff
alleges Defendants violated his Eighth Amendment rights in
regards to treatment of cysts on his testicles. Plaintiff
alleges one count of deliberate indifference to serious
medical needs against Defendants Trost and Lang, and a count
alleging an unconstitutional policy or practice against
Defendant Wexford. This matter is before the Court on two
motions for summary judgment filed by Defendants. (Docs. 54,
59). For the reasons stated below, Defendant Lang's
Motion is GRANTED and Defendants Trost's
and Wexford's Motion is GRANTED in part and
DENIED in part.
Garcia has been an inmate with IDOC since 2007 and has been
incarcerated at Menard since March of the same year.
Defendant Wexford is a company contracted to provide certain
medical services to inmates incarcerated by the Illinois
Department of Corrections (“IDOC”). Defendant
Trost, who is employed by Wexford, was the medical director
at Menard from November 2013 to March 2017. Defendant Lang is
a Correctional Medical Technician (“CMT”) at
incarcerated at Stateville Correctional Center in 2007,
Plaintiff noticed cysts near his bilateral testicles. (Doc.
55-3, p. 4) He reported the cysts to medical staff and was
referred for an ultrasound. (Id.). The ultrasound
revealed epididymal cysts on Plaintiff's testicles-one on
his right testicle measuring 1.4 cm and another on his left
testicle measuring 1.6 cm. (Doc. 55-2, p. 2). Epidydymal
cysts are fluid filled cysts in the tube or duct connecting
the testicle to the vas deferens located above and behind the
testicle. (Id.). While Defendant Trost contends that
such cysts are typically painless, and do not require medical
attention, Plaintiff disputes this contention, stating that
his cysts are painful. Plaintiff, however, acknowledges that
he did not experience any complaints associated with the
cysts until 2009. (Doc. 55-3, p. 4). According to Dr. Trost,
in rare cases, the cysts are removed when they rapidly
increase in size or result in decreased blood flow. (Doc.
55-2, p. 2).
2009, Plaintiff began to experience a burning feeling in his
bilateral testicles, which he rated at a five out of ten.
(Doc. 55-3, p. 4). He submitted a sick call request and was
referred for another ultrasound. (Id.). The
ultrasound was performed on August 17, 2009, and it revealed
the small bilateral epididymal cysts consistent in size as
previously documented. (Doc. 55-2, p. 2). Defendant Trost
first evaluated Plaintiff on May 31, 2013 for complaints of
right shoulder pain and prescribed Ibuprofen. (Id.).
While Defendant maintains that Plaintiff did not complain of
testicular pain during this visit, Plaintiff contends that he
was not allowed to complain since his visit was for shoulder
pain. (Doc. 55-2, p. 2; Doc. 62, p. 7). According to
Plaintiff, inmates are not allowed to complain about issues
other than the ones for which they are scheduled to visit the
doctor. (Doc. 62, p. 7). He testified at his deposition that
he had previously tried to bring up another medical issue
during a visit, but “they wouldn't allow you to do
that.” (Doc. 55-3, p. 10). Plaintiff did not provide
any further specifics or detail other than to say that such
prohibitions were given orally and applied to all healthcare
indicates that he has been in constant pain from his
testicles since August 2013. (Doc. 62, p. 11). Plaintiff
presented to Defendant Lang, a Correctional Medical
Technician, on September 29, 2013, complaining of testicular
pain at a level of six or seven out of ten with swelling for
the previous two and a half months. (Doc. 55-3, p. 10).
According to Defendant Lang, she was not able to visualize
any gross swelling or enlargement. (Doc. 60-3, p. 2). She
referred Plaintiff to see a nurse practitioner or doctor, and
Plaintiff was seen by a nurse practitioner a week later.
(Id; Doc. 60-1, p. 15). Defendant Lang has no
control over scheduling patients' visit, and is not
responsible for doing so. (Doc. 60-3, p. 3). According to
Plaintiff, he requested pain medication from Defendant Lang;
she refused, and walked away from his cell. (Doc. 62, p. 7).
Defendant Lang does not recall if Plaintiff requested
ibuprofen or pain medication from her during this visit.
(Doc. 60-3, p. 2). She is only able to prescribe medication
listed on the IDOC protocol sheet. (Id.).
Regardless, according to Defendant Lang, based on the
protocol sheets and her medical training and judgment,
Plaintiff's condition did not warrant pain medication at
that time. (Id.). She instructed Plaintiff to inform
the healthcare unit if the severity of his pain increased.
was evaluated by a non-party nurse practitioner at Menard on
October 7, 2013. He reported complaints of testicular pain,
and that twice in the past he had experienced pain with
urination and penile discharge. (Doc. 62-, p. 7 - 8). The
nurse practitioner noted cysts on Plaintiff's testicles
that were consistent with the 2007 ultrasound. (Doc. 55-2, p.
3) The NP's assessment was that of testicular pain with a
possible urinary tract infection, and the NP ordered a urinal
analysis and culture and sensitivity for further diagnosis.
(Id.). Plaintiff was also prescribed Bactrim, an
antibiotic, and recommended Plaintiff increase his fluids and
return for reevaluation in two weeks. (Id.).
was seen by the non-party NP again on October 21, 2013.
(Id.). He was diagnosed with testicular pain and was
referred for an evaluation with a medical doctor.
(Id.). Plaintiff was seen by a non-party doctor on
October 31, who, upon finding Plaintiff's cysts to be
consistent with the 2007 and 2009 ultrasounds, diagnosed
Plaintiff with stable bilateral epididymal cysts.
(Id. at 3 - 4). Plaintiff presented to nurse sick
call on December 14, 2013 for complaints of testicular pain,
but was not evaluated due to a dispute over a $5.00 copay.
(Id. at 4; Doc. 62, p. 8).
presented to nurse sick call on April 25, 2014, where he was
evaluated by a non-party nurse for complaints of occasional
testicular pain over the prior weeks, which he rated at a
nine out of ten. (Doc. 55-2, p. 4). He was referred for an
evaluation with a nurse practitioner or a doctor.
(Id.). Plaintiff was seen by Dr. Trost on May 23,
2014 with complaints of bilateral testicular pain, and
Plaintiff was again diagnosed with bilateral epididymal
cysts. (Id.). While both Dr. Trost and the medical
record indicate that Plaintiff was prescribed Ibuprofen,
Plaintiff denies ever receiving Ibuprofen. (Id; Doc.
55-1, p. 11 - 12; Doc. 55-3, p. 17). According to Plaintiff,
he requested pain medication during the May 23rd
visit, and Dr. Trost stated that he would send Plaintiff some
medication that would be delivered to Plaintiff's cell.
(Doc. 62, p. 15). Plaintiff never received any medication,
however. (Id.). He Indicates that nurses pass out
the medication, and at that time, the inmates are required to
sign a medication form to prove reception. (Id.).
Plaintiff never signed such a form. (Id.).
was next seen by a non-party NP on July 1, 2014 who
identified bilateral epididymal cysts with complaints of
tenderness upon palpation. (Doc. 55-2, p. 4). Dr. Trost
indicates that the NP renewed the ibuprofen prescription, but
this notion is disputed by Plaintiff. (Id; Doc. 62,
was seen again by Dr. Trost on July 18, 2014. During that
visit, Plaintiff reported ongoing testicular pain without
improvement, and he requested to have his cysts surgically
removed and to see a urologist. (Doc. 55-2, p. 5). Dr. Trost
submitted Plaintiff to collegial for consideration for a
bilateral orchiectomy, which is the surgical removal of both
testicles. (Id.). According to the referral record,
this was done per Plaintiff's request. (Doc. 551, p. 17).
According to Plaintiff, however, he did not request an
orchiectomy; rather, he sought only the surgical removal of
both cysts. (Doc. 62, p. 9). Regardless of whether Plaintiff
requested an orchiectomy, Dr. Trost's referral was denied
as it was determined that the cysts could be effectively
managed on-site and that an orchiectomy was not medically
necessary. (Doc. 55-2, p. 5).
Trost saw Plaintiff on two occasions in August 2014 for
unrelated issues. (Id.). Plaintiff presented to Dr.
Trost again on October 7, 2014, again complaining of
testicular pain. (Doc. 55-2, p. 5). Dr. Trost referred
Plaintiff for an updated ultrasound. (Id.). The
ultrasound revealed a 1.28 x 1.58 cm cyst on Plaintiff's
right testicle and a 1.7 cm cyst on the left testicle, and
otherwise normal testicles that were consistent with the
prior studies. (Id.). Plaintiff does not ...